Day 1 :
Keynote Forum
Amin Gohary
Burjeel Hospital, UAE
Keynote: Intestinal obstruction in pediatrics
Time : 09:00-09:45
Biography:
Amin Gohary completed his MB BCh in 1972 and his Diploma in General Surgery in 1975 at Cairo University, Egypt. Prof. Dr. Amin is well known in Abu Dhabi for his extensive interest and involvement in scientific activities. He is the President of the Pediatric Surgical Association of UAE. Prof. Dr. Amin is also the founder and member of the Arab Association of Pediatric Surgeons. Currently, he is an external examiner for the Royal College of Surgeons.
Abstract:
Vomiting in children is common and mostly related to medical condition. However there are surgical conditions associated with vomiting which needs to be acknowledge and diagnosed early. Bilious vomiting is an ominous symptom and needs to be taken seriously. Any baby who vomits bile should be considered as having an underlying intestinal obstruction until proved otherwise. Learning Objectives: 1. Recognize the difference between vomiting due to medical and that related to surgical pathology 2. Discuss the different causes of surgical vomiting 3. Review the impact of bilious vomiting and its significance
Keynote Forum
Monika Kaushal
Emirates Specialty Hospital, UAE
Keynote: Supportive care of the sick neonate
Time : 10:15-11:00
Biography:
Monika Kaushal has completed her MBBS, MD Pediatrics, DM Neonatolgy from FRCPCH. She has several publications in journals which are indexed both nationally and internationally indexed journals. She has a great passion for research, teaching and dissemination of knowledge. She is currently pursuing MSc in Neonatology from Southampton University, UK.
Abstract:
Neonates are the future of the society and care of the neonates in the first few days of life is extremely unique. The little ones who have some health problems right after birth need special care in special units like NICU or SCUBU. To take care of these babies especially those who need help for their breathing we need not only especial unit, but especial infrastructures, equipment’s and trained medical professional’s doctors and nurses. Nurses are back bone of the neonatal care. We need to focus on the supportive care which would be required by the sick neonates. Monitoring is most effective tool for efficient ventilation especially in the first few hours. A skilled nurse’s feel good or bad factor on newborn’s clinical picture is to be taken as the most crucial factor for deciding management strategies for the day. It will provide early evidence of potentially dangerous conditions- gas trapping and hyperinflation help to determine optimal PEEP, give immediate feedback on the effects of changes in ventilator parameters and the real-time monitoring would reduce the need for many ancillary tests such as chest X-ray, blood gas analysis, thus decreasing the cost of health care. This will allows better control of some variables. Irrespective of the technique or mode of ventilation chosen, the nursing principles are to identify the most appropriate device, technique and strategy to achieve and maintain adequate pulmonary gas exchange, minimize the risk of lung injury/recognition and prevention of VALI (Ventilator Associated Lung Injury), reduce newborn Work of Breathing (WOB) and Optimize newborn comfort for appropriate oxygenation and appropriate ventilation. Gas transport depends on ventilation, perfusion, hemoglobin and oxygen binding. Surfactant production depends on glucose, oxygen and other nutrition. Long term neurodevelopmental outcome is dependent on maintenance of normal oxygen, BP, glucose, nutrition, developmental care. Family support minimizes stress and optimizes outcomes. Monitoring will include appearance, comfort, color, heart rate, capillary refill time, respiratory rate, chest expansion/ retraction, synchrony, urine output, abdomen, feeding, Central nervous system, pain, breastfeeding, social, emotional and financial. Supportive care would include positioning, physiotherapy, prevention of nosocomial infection, surveillance of flora, provision of in-utero like milieu, minimizing oxygen demand, schedule care activities at one go-club together approach softly and gently, humidification and pulmonary hygiene and suctioning, ABG monitoring, fluid and nutritional support, sedation, analgesia and paralysis, weaning, site and type of IV access, documentation, follow up care, emotional support and good communications.
- Sessions: Pediatric Nursing | Neonatal Nursing | Pediatric and Infectious Diseases and Vaccines | Pediatric Dentistry | Nutrition and Pediatric Diet | Pediatric Disorders
Location: Dubai
Chair
Amin Gohary
Burjeel Hospital, UAE
Session Introduction
Khaled Soliman Balah
Saudi German Hospital, UAE
Title: Pediatric sedation
Time : 11:00-11:45
Biography:
Khaled Soliman Balahis is working as Associate Professor of Anesthesia from Ain Shams University and also Head of Anesthesia in the Department of Saudi German Hospital at Dubai. He has published 7 postdoctoral studies in the field of anesthesia.
Abstract:
Pediatric sedation for diagnostic and therapeutic procedures (pediatric procedural sedation) is an evolving, growing and dynamic field of pediatric practice in any hospital that cares for children. It is practiced by a diverse group of practitioners in an expanding variety of clinical settings. The aim of sedation during diagnostic and therapeutic procedures in children is not only to control behavior and movement to allow safe performance of procedures but in addition to minimize physical pain and discomfort to control anxiety, minimize psychological trauma and maximize amnesia. Pharmacologic and non-pharmacologic interventions that consider the child's developmental status and the clinical circumstances are often required to meet these goals. The increased availability of short-acting sedatives along with accurate noninvasive monitoring and improved sedation training programs has enabled effective and safe management of sedation and analgesia outside the operating room. Among the challenges that must be addressed are the development of standardized definitions of outcomes, particularly with respect to what constitutes satisfactory sedation and what is an adverse event. Unified guidelines would encourage consistent care across specialties.
Karthikeyan Gengaimuthu
International Modern Hospital, UAE
Title: Non-invasive respiratory support of neonates: The non-traumatic way forward!
Time : 11:45-12:15
Biography:
Karthikeyan Gengaimuthu is a Senior Consultant Neonatologist currently working in International Modern Hospital, Dubai. He has completed his MBBS from Madurai Kamaraj University, Madurai and MD in Pediatrics from JIPMER, Pondicherry.
Abstract:
The quality of care in a Neonatal Intensive Care Unit (NICU) is judged by the standards of respiratory care the babies receive in the unit and the bedside care therein is given by the surrogate mothers of the tiny tot in the baby cot (incubator) read the NICU sisters. Appropriate and up to date technologies of respiratory support are the aces up the sleeves of the neonatologists that ensure intact survival of premature babies against the odds of barotraumas, volutrauma, bio-trauma etc. The level of escalation of respiratory support of neonates extends from oxygen therapy to continuous distending airway pressure devices, surfactant, nasal positive pressure ventilation, intubation and ventilation (including high frequency oscillation) and Extra- Corporeal Membrane Oxygenation (ECMO). Keeping the lungs expanded to prevent atelectrauma is a key strategy in neonates as this conserves surfactant and this support starts from the delivery room for premature babies. Disruptions of airway mucosal integrity and mucociliary function have deleterious consequences and hence gentle strategy of respiratory support avoiding intubation to the extent possible is advocated. High Flow Nasal Cannula oxygen (HFNC) therapy aims to minimize even the nasal mucosal injury that can happen with the current nasal respiratory support devices. Although the threshold for surfactant therapy varies between NICUs, the earlier is better and the aim is to keep the FiO2 below 0.3 or 0.4. The INSURE (INtubate, Surfactant and Extubate) was evolved earlier to minimize the duration of intubation needed to administer surfactant. Earlier in this decade even this has been replaced by the Minimally Invasive Surfactant Therapy (MIST) wherein surfactant is administered using a no intubation technique. Dubai has a published report on MIST in our NICU recently. The evidence base and meta-analysis have attested to the superiority of non-invasive respiratory support strategies and the initial follow up data available in the literature is encouraging.
Biography:
Shapule Modjadji is finalising PhD which is being currently edited for final submission with the University of Limpopo in South Africa. Also, she is currently working on producing two papers from this study. She have attended International Conference of Maths, Science and Technology education (ISTE) arranged by UNISA in 2013, Wits International Conference of Language and Literacy Education in August 2016.
Abstract:
The current research study investigates change in health practices and knowledge due to intervention considering co-variables and changes in health attitude, subjective norm and self-efficacy. A sample of 324 students from rural primary schools in Dikgale village participated in the study. A questionnaire was used to collect data. The main findings of the study includes; 1. Students in the experiment condition did not reflect more health related practices (F(1.315)=0.20; p>887) considering co-variables and changes in health attitude, subjective norm and self-efficacy. 2. Students in the experiment condition reflected more health related knowledge (F(1.315)=115.72; p<0.001) considering co-variables and changes in health attitude, subjective norm and self-efficacy. In addition, 53.8% of the differences between both groups seem related to the intervention. The results suggest that even if there can be changes in knowledge due to intervention, healthy practices may be difficult to change. Further interventions should be in place in communities like Dikgale because knowledge alone cannot decrease the prevalence of NCDs.
Kuldip Shah
Cherish Child Dental Care, India
Title: Grow up with a healthy smile: Insight of pediatric dentistry- A recent concept
Biography:
Kuldip Shah has completed his BDS from Rajasthan University of Health Sciences and Post-graduation in Pedodontics and Preventive Dentistry from Pacific University. He is currently working as a Practitioner at Cherish Child Dental Care. He has published more than 10 papers in reputed journals
Abstract:
Journey of thousand miles starts with a single step likewise journey of life starts with infancy. So starting from infancy to childhood to adolescence, there is an important role of a person who takes care of good oral hygiene throughout this journey, is a pediatric dentist. By being an age-specific specialty, pediatric dentistry encompasses disciplines such as behavior guidance, care of the medically and developmentally compromised and differently abled patient, supervision of orofacial growth and development, caries prevention, sedation, pharmacological management and hospital dentistry, as well as other traditional fields of dentistry. Good pedodontic practice never starts at clinic but it starts at home with proper brushing, patient education, diet counselling and motivation. In the beginning pediatric dentistry was mainly concerned with extraction and restorations. The trend changed from extraction to preservations. Presently the concept of pediatric dental practice is prevention and concentrating on minimal invasion. Any curative treatment provided should be minimally invasive, preferably nonsurgical and conserve tooth structure as much as possible. In addition, an inadequate and unsatisfactory dental treatment during childhood can permanently damage the entire masticatory apparatus of the child leaving him with many dental problems commonly encountered in today’s adult population. Long lasting beneficial effects also can result when the seeds for future dental health are planted early in life. Oral health needs of children who are the bright future of our globe have to be upraised. Children are same all over the world. Languages, customs and religions may differ, but the motto grow up with a healthy smile remains allover and forever.
Biography:
Ola Asa’ad is a clinical dietitian and master practitioner in eating disorders and obesity with 16 yrs of experience. She holds Bachelor degree in Nutrition & Dietetics from the University Of Jordan and Masters degree from UCL university/London in Eating Disorders& Obesity. She is the Founder and owner of Quality of Life nutrition and well-being Center working with a wonderful team of 4 dietitians to make a change in people’s lives. Also, She is the Founder of Primrose health food shop changing the notion of fast ,nutritious yet delicious meals in addition to providing free meals for charities as a sub-feeding suppliers.
Abstract:
Obesity is one of the major nutrition-related disorders, and its rapid rise in the whole world has been paralleled with a dramatic shift from traditional, more nutritionally dense dietary patterns toward more energy-rich, unhealthy patterns. The importance of nutrition in prevention and treatment of obesity has gained much attention from public health professionals. The etiology of obesity is multifactorial and involves complex interplays between dietary factors and various ‘internal’ (e.g., genomic, epigenomic, and metabolic profiles) or external (e.g. lifestyle) exposures. The past 10 years have witnessed speedy advances in research of genomics, which has made great strides in detection of genetic variants associated with body weight regulation and obesity. In addition, emerging data have shown that the genetic variants may interact with dietary factors in relation to obesity and weight change. Moreover, recent studies on other global characteristics of the human body, such as epigenomics and metabolomics, suggest more complex interplays may exist at multiple tiers in affecting individuals’ susceptibility to obesity, and a concept of ‘personalized nutrition’ has been proposed to integrate these new advances with traditional nutrition research. The root of obesity etiology is imbalance between dietary energy intake and energy expenditure. Human evolution has favored a preference for energydense and fatty foods, as a consequence of exposure to ancestral famine. This leaves humans susceptible to modern obesogenic environments regarding rise of energy intakes and subsequent elevation of obesity risk. Data from the National Health and Nutrition Examination Survey have shown a marked upward shift of energy intake, increasing by 7% in men and 22% in women from 1971-1974 to 1999-2000, in parallel with a rapid increment of obesity in the same period of time.
Biography:
S K Mohanasundari is currently pursuing PhD in INC and working in College of Nursing as Faculty in AIIMS Jodhpur, India. She has published more than 40 articles in various national and international journals and published one book (Entrance Guide for Nurses to Succeed). She is the Member of Editorial and Review Board of three national and two international journals and Life Member of four associations such as TNAI, NRSI, IANN and NNF. She received Best Lecturer Award from Tayma General Hospital, Saudi Arabia. She has worked as an Assistant Professor in private nursing colleges in India, also worked in MOH Saudi Arabia as a Nurse Educator (2013 to 2014) and later worked in All India Institute of Medical Sciences Rishikesh, India. Presently she is working in College of Nursing as Faculty in All India Institute of Medical Sciences Jodhpur, India.
Abstract:
Neonatal nursing is a subspecialty of nursing. Neonatal nursing generally encompasses care for those infants who experience problems shortly after birth, but it also encompasses care for infants who experience long-term problems related to their prematurity or illness after birth. A few neonatal nurses may care for infants up to about 2 years of age. Most neonatal nurses care for infants from the time of birth until they are discharged from the hospital. Healthcare institutions have varying entry-level requirements for neonatal nurses. Neonatal nurses are Registered Nurses (RNs). Some countries or institutions may also require a midwifery qualification. Some institutions may accept newly graduated RNs who have passed the NCLEX exam; others may require additional experience working in adult-health or medical/surgical nursing. Some countries offer postgraduate degrees in neonatal nursing and various doctorates. A nurse practitioner may be required to hold a postgraduate degree. The National Association of Neonatal Nurses recommends two years' experience working in a NICU before taking graduate classes. All nurses working in a birthing centre have an important role in assessing the newborn immediately after birth. There are four different levels of neonatal nursery where a neonatal nurse might work. Such as Level I – It consists of caring for healthy newborns, Level II - provides intermediate or special care for premature or ill newborns, Level III- the Neonatal intensive-care unit (NICU), treats newborns who cannot be treated in the other levels and are in need of high technology to survive, such as breathing and feeding tubes, and Level IV- includes all the skills of the level III but involves the extensive care the most critically and complex newborns. There have been some major changes in the Neonatal Care over the past 120 years. Some of these changes include the invention of the incubator, changes in respiratory care, and the development of surfactants. Duties of a neonatal nurse usually include supplying vital nutrients to newborns, changing feeding tubes, administering medication, observing vital signs, performing intubations and using monitoring devices. In the common situation where premature and sick newborns' lungs are not fully developed, they must be certain infants are breathing and maturing properly. All nurses working in a birthing centre have an important role in assessing the newborn immediately after birth. Neonatal nurses work together with upper-level nurses and physicians to facilitate treatment plans and examinations. Neonatal nurses can also work with speech-language pathologists who specialise in the assessment and treatment of feeding, swallowing and communication in preterm infants. They have regular interaction with patients' families, therefore are required to educate parents or relative on the infant's condition and prepare care instructions after the infant is discharged from the hospital.
Biography:
Jane Darakjian is a multi-lingual (Armenian, Arabic, English, French; Graduated pre- medicine BS degree from LAU (Lebanese American University which is affiliated with The States University of New-York. Obtained her (PhD) in Human Nutrition and Dietetics from medical University. Further she advanced in Functional nutrition and exercise therapist. Her first practice and experience was Hotel D’ieu French hospital in Beirut where and Rejuvenate Health Therapy clinic under supervision of Dr Tony Licha after she re-located to Dubai. Over 16 years she practiced the Head of the Clinical dietician Department covering: oncology, dyslipidemia, metabolic syndrome, chronic conditions, diabetes and much more. Recently she practice at Amwaj Polyclinic in the Wellness department as the head of the department.
Abstract:
The modern technology ways of influence an importance on pediatric nutrition among toddlers, children’s and teenagers health. A global public health crisis announced that this is the most common chronic disease of childhood affecting more than 38% of children source. Whether there is a connection of children’s health education and prioritizing systems for their development can correlate with modern life for their wellness and wellbeing. The association between pediatric dietary sources and various diseases like obesity, diabetes, thyroid and risk factors is a complex process. The focus based on the essential nutrients strategy for children’s at different types and levels. The role of nutrients intakes are reported to modify genetic susceptibility to diseases such as obesity, with the expectation that this would provide a scientific basis for cancer prevention via dietary modification. It is crucial for the controversies of increase risk of nutrients deficiency and obesity among young generation that leads to life serious health problems. The role of simple sugar at this point and more…!! Myths..!! The history and the concept of preventing the consequences of obesity growth and reversely effect of nutrients deficiency have been studied since 1976. The effective intervention strategies are being used to prevent and control obesity in children including a variety of interventions and governmental actions addressing obesity and the challenges ahead for managing this epidemic. Some case study will be covered and discussed about childhood obesity and whether exercise is associated to lower obesity and its consequences.
Biography:
Monika Suri, based in Gurgaon, India, have completed B.Sc. Life Sciences (1993–1996) from Govt. P.G. College, Gurgaon, Haryana, India (Awarded “Roll of Honour” by MDU, Rohtak for first position in state level science exhibition and distinction in botany and zoology), then M.Sc. (Dietetics and Food Service Management and aspires to pursue PhD from a recognized university. She holds CFN Certificate in Food and Nutrition, PGDBM (MBA) and Food safety certificate of competence (FSSAI).
Abstract:
Knowledge, attitude and practices affect the dietary intake and nutritional status. Dietary intake is considered one of the key factors in prevention and management of diabetes mellitus. The aim of this study was to assess the knowledge, attitude and practices and analyze the dietary intake of the type-2 diabetes mellitus patients living in Gurugram, Haryana. This was a cross- sectional study conducted on 138 type-2 diabetes mellitus patients attending OPD at two different diabetic centers in Gurugram city. Socio-economic status, duration of diabetes, blood pressure, fasting and post-prandial blood glucose levels, nutritional status and knowledge-attitude-practices of type-2 diabetes mellitus patients were studied. The study included 47% males and 53% females, majority of the patients (37%) were in the age group 46-50 years. Anthropometric assessment suggested that 49% subjects were in the pre-obese category. 45% males and 49% females had high waist-hip ratio. The mean ±SD fasting and post-prandial blood glucose for males was 141.9±39.2 mg/dl and 178.8±46.7 mg/dl, respectively. The mean and post-prandial blood glucose for females was 152.1±38.8 mg/ dl and 199.1±56.6 mg/dl, respectively. The blood pressure assessment revealed 74% males and 59% females in the pre-hypertensive category. Food and nutrient intake data revealed that the mean ±SD of energy intake was 1470.7±176.8 kcal and 1267.5±102.4 kcal for males and females, respectively which was found to be 98% and 106% adequate for males and females, respectively. The protein intake for both males and females was inadequate at 77% and 80%, respectively. Dietary fiber intake was also inadequate at 69% and 80% for males and females, respectively. The intake of micronutrient magnesium was also inadequate at 77% and 89% for males and females, respectively. Data related to knowledge about diabetes revealed that 44% subjects had good knowledge scores and 53% subjects had average knowledge scores. The mean score of attitude of the subjects was 3.5±3.6 on Likert scale thus indicating a positive attitude. The practices assessment suggested that 63% subjects had their medicines regularly, 41% subjects do physical exercise daily, and 68% subjects monitor blood glucose on regular basis (two-three times a month). The study revealed that friends and media played a crucial role as a source of dietary information. On the basis of the knowledge-attitude-practices of the subjects regarding diabetes, interventions may be planned.
Biography:
Nasser Mohamed has almost 30 years of experience as Neonatologist and Pediatric Intensivist. He has graduated MBBCh in 1989 from Zagazig Faculty of Medicine, Egypt and did Residency program in Mataria Teaching Hospital, Egypt. He has obtained his Master’s degree of Pediatrics in 1994 and then was moved to work in Kuwait where he spent 20 years working between NICU and PICU Mubark Al Kabeer University Hospital. In 2015 he joined Sheikh Khalifa Medical City PICU managed by Cleveland Clinic in Abu Dhabi as Pediatric Intensivist Specialist. He is a Senior Consultant of Pediatrics in Egypt and during this period he has participated in many of international pediatric conferences as speaker and he shared many of workshops in field of pediatric health care.
Abstract:
Extravasation of medications during Peripheral Intravenous (PIV) therapy can result in harm to pediatric patients. These medications have physical and/or biologic factors that cause tissue damage. Extravasation injury is a common phenomenon in hospitals. Failure to detect and treat extravasation injury can lead to irreversible local injuries, tissue necrosis and malfunction of the affected tissue. Until now, it is largely unknown about incidence, risk factors and treatment outcomes of extravasation in pediatric patients. The aim of this presentation is to explore the risk factors, to detect early signs and symptoms of extravasation to react early with active management. Extravasation injuries are a common and challenging problem in hospitalized newborns. Accidental infusion leakage into the surrounding tissues in immature infants may frequently result in skin necrosis, with significant risk of functional and cosmetic impairment. Vesicant extravasation injuries can occur in patients receiving chemotherapy despite best efforts to prevent them. Most extravasation injuries are of Grades 1 & 2 and do not require extensive intervention to prevent long-term skin and soft tissue damage Grade 3 & 4 injuries have a greater potential for skin necrosis, compartment syndrome and need for future plastic surgery, depending on the type of solution extravasated. Evidence suggests hyaluronidase irrigation for parenteral nutrition and calcium chloride extravasation is beneficial. The patients` information including age, gender, injection site, estimated volume of solution extravasated, patient symptoms, severity of extravasation injury, treatment methods, and outcomes must be documented . All extravasations are treated with physical, pharmacological and surgical intervention according to the grade of injuries in the most severe cases plastic surgeons are often summoned to assess the extent of the injury and the possibility for reconstruction. Systematic implementation of intervention can alleviate the extravasation injuries and improve the patients` outcome. Learning Objective This presentation will highlighted on Ricks factors of extravasation and how to avoid it Medications may cause extravasation Grads of extravasation Evaluation the signs and symptoms of a vesicant extravasation Documentations of extravasation progress and action of management and outcome Administer the FDA-approved vesicant extravasation treatments and antidotes. Antidote preparation and administration instruction Follow up patients with extravasation after management.